Circumferential para-aortic masses: computed tomographic observations

Of 59 patients in whom computed tomography (CT) demonstrated large para-aortic masses engulfing the aorta, lymphoma was responsible in 32 (54%). In 22 (69%) of these 32 patients the mass appeared confluent while in 10 some nodularity could be discerned. Thirty-five of the 59 patients were known to have an underlying malignancy at the time of the CT; in every case the underlying malignancy proved to be responsible for the mass. Amongst 24 patients in whom the CT abnormality was found in the course of initial diagnosis, lymphoma proved to be responsible in 11 (46%), periaortitis in 4 (17%) and various malignancies in 9 (38%). In none of the patients with periaortitis was the aorta displaced from the vertebral body. The combination of such aortic displacement and mesenteric lymphadenopathy is highly characteristic of non-Hodgkin's lymphoma. Knowledge of these results should assist the choice of the appropriate type of biopsy in this situation.